GEORGE DERMATOLOGY, LLC (NPI# 1275046773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275046773 |
| Entity Type | Organization |
| Organization Name | GEORGE DERMATOLOGY, LLC |
| Practice Address |
12255 Depaul Drive 770 North Building Bridgeton MO 63044-2515 |
| Mailing Address |
12255 Depaul Drive 770 North Building Bridgeton MO 63044 |
| Practice Telephone | 3143440004 |
| Practice Fax Number | 3143440631 |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | MS. MARY NOEL GEORGE (OWNER) |
| Authorized Official Telephone | 3143440004 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 2006009450 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
12255 DEPAUL DRIVE 770 NORTH BUILDING |
| City | BRIDGETON |
| State | MO |
| Zip Code | 63044-2515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912905134 | Marco A Castaneda | Surgery | 12255 Depaul Drive, #675n, Bridgeton, MO 63044 | 2005-07-12 |
| 1699305334 | Lisa Marie Schuster | Registered Nurse | 12255 Depaul Drive, Suite 600, Bridgeton, MO 63044-2515 | 2020-01-22 |
| 1851942874 | Audiology Consultants, LLC | Audiologist | 12255 Depaul Drive, Suite 860 North, Bridgeton, MO 63044 | 2019-09-20 |
| 1437611720 | Hannan Zahid | Student in an Organized Health Care Education/Training Program | 12255 Depaul Drive, Bridgeton, MO 63044 | 2019-04-04 |
| 1174028195 | North County Internists Inc | Internal Medicine | 12255 Depaul Drive, Suite 260, Bridgeton, MO 63044-2510 | 2018-03-30 |
| 1043719404 | Shannon Marie Lefler | Student in an Organized Health Care Education/Training Program | 12255 Depaul Drive, Suite 860 North, Bridgeton, MO 63044-2515 | 2018-02-12 |
| 1053822254 | Amy Elizabeth Mcalister | Nurse Practitioner | 12255 Depaul Drive, Suite 370, Bridgeton, MO 63044 | 2017-10-16 |
| 1356872089 | Kristy A Thomas | Dietitian, Registered | 12255 Depaul Drive, Ste 420, Bridgeton, MO 63044-2510 | 2017-03-24 |
| 1285004598 | Ssm Medical Group Inc. | Pain Medicine | 12255 Depaul Drive, Suite 120, Bridgeton, MO 63044 | 2015-09-29 |
| 1700268331 | Elin Cogan-adewunmi | Social Worker | 12255 Depaul Drive, Suite 500, Bridgeton, MO 63044 | 2015-06-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073150017 | Zoe Marie Wadsworth | Nurse Practitioner | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | 2019-12-10 |
| 1609412451 | Beyond Better, Best Home Health Care Services, Limited Liability Corpo | In Home Supportive Care | 3430 Mckelvey Road Ste B, Bridgeton, MO 63044 | 2019-11-26 |
| 1275189078 | Delicate Angels Home Health LLC | Home Health | 11726 St. Charles Rock Road Suite G, Bridgeton, MO 63044 | 2019-08-16 |
| 1588210082 | Nicholas Huber | Physical Therapist | 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 | 2019-08-12 |
| 1124688858 | Michelle Bassett | Registered Nurse | 11520 St. Charles Rock Rd., Suite 106, Bridgeton, MO 63044 | 2019-06-14 |
| 1336703883 | Elena A Barrow | Nurse Practitioner | 12255 Depaul Dr, Suite 260, Bridgeton, MO 63044 | 2019-04-30 |
| 1487123105 | Laura N Steiner | Registered Nurse | Gateway Pediatrics, Ltd, 12255 Depaul Drive, Suite 460 North Medical Building, Bridgeton, MO 63044 | 2018-11-26 |
| 1205310950 | Danielle Mathis | Nurse Practitioner | 3440 Depaul Lane Suite 201, Bridgeton, MO 63044 | 2018-09-19 |
| 1588163570 | Thoughts Out Loud Counseling, LLC | Social Worker | 11520 St. Charles Rock Road Suite 101, Bridgeton, MO 63044 | 2018-02-06 |
| 1912411430 | Breanna Victoria Hayes | Counselor | 3165 Mckevley Road, Suite 200, Bridgeton, MO 63044 | 2017-11-20 |
| Find all providers in zip 63044 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396811105 | Bruce J Hookerman | Dermatology | 12105 Bridgeton Square Drive, Bridgeton, MO 63044-2616 | 2006-11-27 |
| 1427171040 | Lbr Inc | Dermatology | 12255 De Paul Dr, 845, Bridgeton, MO 63044-2559 | 2007-04-09 |
| 1427116680 | Dermatology Specialists Inc | Dermatology | 12105 Bridgeton Square Drive, Bridgeton, MO 63044-2616 | 2006-12-04 |
| 1700998077 | Mary Noel George | Dermatology | 12255 Depaul Dr, #845 - North, Bridgeton, MO 63044-2530 | 2006-08-31 |
| 1104871599 | Lisa B Ring | Dermatology | 12255 De Paul Dr, #845, Bridgeton, MO 63044-2530 | 2006-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922605906 | Deluxe Dermatology LLC | Dermatology | 1034 S Brentwood Blvd Ste 1000, Saint Louis, MO 63117-1210 | 2020-10-03 |
| 1811510886 | Yoon Dermatology LLC | Dermatology | 1060 Meyer Rd, Wentzville, MO 63385-3800 | 2020-05-25 |
| 1417597923 | Anna Marie Aiazzi | Dermatology | 10012 Kennerly Rd Ste 401, Saint Louis, MO 63128-2197 | 2020-01-13 |
| 1790330371 | Baydon Earl Hilton | Dermatology | 1003 Kings Rd, Kirksville, MO 63501-2627 | 2019-08-09 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1528537057 | Cayce Medical Spa, Inc | Dermatology | 2001 Corona Rd Ste 201, Columbia, MO 65203-5924 | 2018-11-14 |
| 1396226981 | Nicole Betty | Dermatology | 413 W Water Street, Greenfield, MO 65661 | 2018-08-22 |
| 1366946832 | Novahealth Medical Group, LLC | Dermatology | 3208 Lemone Industrial Blvd Ste A, Columbia, MO 65201-8244 | 2018-03-20 |
| 1952757007 | Stacy Gittel Blum | Dermatology | 222 S Woods Mill Rd Ste 480, Chesterfield, MO 63017-3625 | 2016-05-08 |
| 1508248576 | Kaitlin Ann Schiavo | Dermatology | 204 N Keene St Ste 100, Columbia, MO 65201-8136 | 2015-06-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.